Ulcerative Colitis

Question 1

Which of the following is NOT true of ulcerative colitis?

A) Can affect any age group
B) Affects males and female equally
C) More common in smokers
D) Most commonly presents with bloody diarrhoea

Answer 1

C) More common in smokers

UC is one of the few diseases in which smoking seems to be slightly protective. It is more common in non-smoker or ex-smokers.

Smoking is a risk factor for Crohn’s disease.

Question 2

Which of the following is NOT true of ulcerative colitis?

A) Affects submucosa
B) Only affects the colon
C) Usually starts at the anorectal margin, extends proximally
D) Incidence rates are currently stable

Answer 2

A) Affects submucosa

This is incorrect. In UC, inflammation is limited to the mucosa.

Leads to crypt distortion and abscess formation, loss of goblet cells.

Submucosal or transmural inflammation is commonly seen in Crohn’s disease.

Question 3

True or false: Appendicectomy is protective against ulcerative colitis.

Answer 3

True

Question 4

True or false: colectomy is curative for ulcerative colitis?

Answer 4

True

UC only affects the colon. By removing the colon you remove the possibility of having UC.

Question 5

Which marker may predispose an individual to UC?

Answer 5

HLA-B27

Question 6

What are the risk factors for UC?

Answer 6

Family history of IBD

HLA-B27

Infection

NSAIDs

Non-smoker/ex-smoker

Question 7

How might someone with UC present?

Answer 7

Rectal bleeding (hallmark)

Diarrhoea (+/- blood, mucus)

Abdo cramps/discomfort

Question 8

What signs might be found on examination of a patient with UC?

Answer 8

Often unremarkable

If severe, may have:

• Fever
• Orthostatic hypotension
• Tachycardia
• Abdo distention and tenderness
• Frank blood on DRE
• Clubbing